ACLS PRE TEST COMPREHENSIVE EXAM
STUDY GUIDE 2026 QUESTIONS WITH
SOLUTIONS
● Which intervention is most appropriate for the treatment of a patient in
asystole? Answer: Epinephrine
● You arrive on the scene with the code team. High-quality CPR is in
progress. An AED has previousy advised "no shock indicated." A rhythm
check now finds asystole. After resuming high-quality compressions,
which action do you take next? Answer: Establish IV or IO access
● A patient is in cardiac arrest. Ventricular fibrillation has been
refractory to a second shock. Which drug should be administered first?
Answer: Epinephrine 1 mg IV/IO
● A 62-year-old man suddenly experienced difficulty speaking and left-
sided weakness. He meets initial criteria for fibrinolytic therapy, and a
CT scan of the brain si ordered. Which best describes the guidelines for
antiplatelet and fibrinolytic therapy? Answer: Hold aspirin for at least 24
hours if rtPA is administered
,● A patient is in refractory ventricular fibrillation and has received
multiple appropriate defribillation shocks, epinephrine 1 mg IV twice,
and an initial dose of amiodarone 300mg IV. The patient is intubated.
Which best describe the recommended second does of amiodarone for
this patient? Answer: 150 mg IV push
● A 35-year-old woman has palpitations, light-headedness, and a stable
tachycardia. The monitor shows a regular narrow-complex QRS at a rate
of 180/min. Vagal maneuvers have not been effective in terminating the
rhythm. An IV has been established. Which drug should be
administered? Answer: Adenosine 6mg
● A patient is in cardiac arrest. Ventricular fibrillation has been
refractory to an initial shock. If no pathway for medication
administration is in place, which method is preferred? Answer: IV or IO
● What is the indication for the use of magnesium in cardiac arrest?
Answer: Pulseless ventricular tachycardia-associated torsades de pointes
● A patient has a rapid irregular wide-complex tachycardia. The
ventricular rate is 138/min. He is asymptomatic, with a blood pressure of
110/70 mm Hg. He has a history of angina. What action is recommended
next? Answer: Seeking expert consultation
● A patient is in cardiac arrest. High-quality chest compressions are
being given. The patient is intubated, and an IV has been started. The
, rhythm is asystole. What is the first drug/dose to administer? Answer:
Epinephrine 1mg IV/IO
● A patient is in refractory ventricular fibrillation. High-quality CPR is
in progress. One does of epinephrine was given after the second shock.
An antiarrhythmic drug was given immediately after the third shock.
You are the team leader. Which medication do you order next. Answer:
Epinephrine 1 mg
● A patient with possible STEMI has ongoing chest discomfort. What is
a contraindication to nitrate administration? Answer: Use of a
phosphodiestrase inhibitor within the previous 24 hours
● A 57-year-old woman has palpitation, chest discomfort, and
tachycardia. The monitor shows a regular wide-QRS at a rate of
180/min. She becomes diaphoretic, and her blood pressure is 80/60 mm
HG/ Which action do you take next? Answer: Perform electrical
cordioversion
● A patient with STEMI has ongoing chest discomfort. Heparin 4000
units IV bolus and a heparin infusion of 1000 units per hour are being
administered. The patient did not take aspirin because he has a history of
gastritis, with was treated 5 years ago. What is your next action?
Answer: Give aspirin 160-325 mg to chew
STUDY GUIDE 2026 QUESTIONS WITH
SOLUTIONS
● Which intervention is most appropriate for the treatment of a patient in
asystole? Answer: Epinephrine
● You arrive on the scene with the code team. High-quality CPR is in
progress. An AED has previousy advised "no shock indicated." A rhythm
check now finds asystole. After resuming high-quality compressions,
which action do you take next? Answer: Establish IV or IO access
● A patient is in cardiac arrest. Ventricular fibrillation has been
refractory to a second shock. Which drug should be administered first?
Answer: Epinephrine 1 mg IV/IO
● A 62-year-old man suddenly experienced difficulty speaking and left-
sided weakness. He meets initial criteria for fibrinolytic therapy, and a
CT scan of the brain si ordered. Which best describes the guidelines for
antiplatelet and fibrinolytic therapy? Answer: Hold aspirin for at least 24
hours if rtPA is administered
,● A patient is in refractory ventricular fibrillation and has received
multiple appropriate defribillation shocks, epinephrine 1 mg IV twice,
and an initial dose of amiodarone 300mg IV. The patient is intubated.
Which best describe the recommended second does of amiodarone for
this patient? Answer: 150 mg IV push
● A 35-year-old woman has palpitations, light-headedness, and a stable
tachycardia. The monitor shows a regular narrow-complex QRS at a rate
of 180/min. Vagal maneuvers have not been effective in terminating the
rhythm. An IV has been established. Which drug should be
administered? Answer: Adenosine 6mg
● A patient is in cardiac arrest. Ventricular fibrillation has been
refractory to an initial shock. If no pathway for medication
administration is in place, which method is preferred? Answer: IV or IO
● What is the indication for the use of magnesium in cardiac arrest?
Answer: Pulseless ventricular tachycardia-associated torsades de pointes
● A patient has a rapid irregular wide-complex tachycardia. The
ventricular rate is 138/min. He is asymptomatic, with a blood pressure of
110/70 mm Hg. He has a history of angina. What action is recommended
next? Answer: Seeking expert consultation
● A patient is in cardiac arrest. High-quality chest compressions are
being given. The patient is intubated, and an IV has been started. The
, rhythm is asystole. What is the first drug/dose to administer? Answer:
Epinephrine 1mg IV/IO
● A patient is in refractory ventricular fibrillation. High-quality CPR is
in progress. One does of epinephrine was given after the second shock.
An antiarrhythmic drug was given immediately after the third shock.
You are the team leader. Which medication do you order next. Answer:
Epinephrine 1 mg
● A patient with possible STEMI has ongoing chest discomfort. What is
a contraindication to nitrate administration? Answer: Use of a
phosphodiestrase inhibitor within the previous 24 hours
● A 57-year-old woman has palpitation, chest discomfort, and
tachycardia. The monitor shows a regular wide-QRS at a rate of
180/min. She becomes diaphoretic, and her blood pressure is 80/60 mm
HG/ Which action do you take next? Answer: Perform electrical
cordioversion
● A patient with STEMI has ongoing chest discomfort. Heparin 4000
units IV bolus and a heparin infusion of 1000 units per hour are being
administered. The patient did not take aspirin because he has a history of
gastritis, with was treated 5 years ago. What is your next action?
Answer: Give aspirin 160-325 mg to chew
